AB1458-HPR Work participation of people with musculoskeletal disorders in ireland: a qualitative multi-stakeholder analysis

Abstract

Background: Musculoskeletal disorders (MSD's) are a leading cause of work disability. Good work offers many potential benefits to employees with MSDs. Understanding the perspectives of all the players involved in helping people with MSD's to stay at, return to and remain in work will advance understanding of work related interventions and services. Given the varying health and social insurance systems across international contexts there is a need to develop contextually specific knowledge. Objective(s): To explore in-depth the perspectives of multiple stakeholders involved in helping people with MSD's stay at, return to or remain in work. Method(s): In-depth qualitative interviews were completed with people with MSD's, health professionals, and employers to explore their perspectives on what factors support people with MSD's to stay in, return to, or remain in work in Ireland. Data were analysed using thematic analysis. Result(s): Across all stakeholder groups biological factors were most implicated as the reason for work absences and the resolution of symptoms was identified as the single greatest enabler of return to work. Although pockets of good practice were identified, in the main, health professionals and employers describe uncertainty about their role and responsibilities and describe a narrow scope of practice. Patients report a mostly adversarial experience of vocational supports. Conclusion(s): Irish vocational rehabilitation stakeholders do not report awareness of the complex interplay of biological, psychological and social factors influencing work participation for people with MSD's. Vocational supports and services are hampered by role uncertainty and consequentially adversarial experiences for service users.